Bulletin 241203 — Temporary increases for primary care and alternate payment programs
The ministry will temporarily increase physician payments by an additional 9.95% for the period January 1, 2025 to March 31, 2025.
To: Primary Care Physicians
Category: Physician Services; Primary Health Care Services
Written by: Provider Services Branch, Physician and Provider Services Division
Date issued: December 24, 2024
Bulletin Number: 241203
Physician Services Agreement initiatives effective January 1, 2025
The Ministry of Health (the ministry) and the Ontario Medical Association (OMA) have been working together to implement physician compensation increases in accordance with the Arbitration Award (Award) for Year 1 of the 2024-2028 Physician Services Agreement (PSA).
The ministry and the OMA have agreed to implement an interim 9.95% compensation increase on physician payments for services rendered during the period of January 1, 2025 to March 31, 2025.
The temporary 9.95% increase will be applied as an across the board (ATB) increase to the value of Fee Schedule Codes (FSCs). This will be achieved through an update to the Fee Schedule Master (FSM). The Schedule of Benefits for Physician Services will not be updated for the temporary increase.
The 9.95% ATB compensation increase for Year 1 of the 2024-2028 PSA will be combined with the 2.8% ATB compensation increase from Year 3 of the 2021-2024 PSA, resulting in a compounded increase of 13.0286% to Fee-for-Service (FFS) payments for services rendered between January 1, 2025 and March 31, 2025.
Temporary compensation increase effective January 1, 2025
Effective January 1, 2025, the payment elements under your funding agreement identified in the table “Payment Increase Application by Contract Type” will be increased by an additional 9.95% and will be reflected on your Remittance Advice (RA) beginning in February 2025. Please note, the compounded Year 1 and Year 3 increases will result in a total increase of 13.0286%.
Effective January 1, 2025, the FSM will be updated to reflect the additional 9.95% increases to Primary Care Q-codes. Claims processed through the OHIP claims system with a service date between January 1, 2025 and March 31, 2025 will reflect these increases and will be reported on your RA.
The interim additional 9.95% compensation increase for the period of January 1, 2025 to March 31, 2025 will only apply to funding agreement items specified below, funding agreements and/or payment elements not listed below will be made through a subsequent payment process. Further details of this payment will be provided in a subsequent INFOBulletin.
Payment Increase Application by Contract Type
Contract Type | 9.95% Application |
---|---|
Aboriginal Family Health Team (AFHT) |
|
Blended Salary Model (BSM) |
|
Comprehensive Care Model (CCM) |
|
Family Health Group (FHG) |
|
Family Health Network (FHN) |
|
Family Health Organization (FHO) |
|
GP Focus Practice (GPFP) Care of the Elderly (COE) |
|
GP Focus Practice (GPFP) HIV |
|
GP Focus Practice (GPFP) Palliative Care (PC) |
|
Group Health Centre (GHC) |
|
Inner City Health Associates (ICHA) |
|
Rural and Northern Physician Group Agreement (RNPGA) |
|
Shelter Health Network (SHN) |
|
St. Joseph’s Health Centre (SJHC) |
|
Sherbourne Physician’s Group (SPG) |
|
Toronto Palliative Care Associates (TPCA) |
|
Waterloo Region Inner City Physician Group (WRICPG) |
|
Primary Care Special Premiums & Programs
Eligible Special Premiums and Programs will be temporarily increased by an additional 9.95% effective January 1, 2025 through to March 31, 2025:
- Office Practice Administration (OPA)
- Group Management & Leadership (GMLP)
- Rurality Gradient Premium
- Cumulative Preventive Care Management Bonus
- Community Palliative Care On-Call (CPOC)
Specialist Physician Alternative Payment Plans
Physician contract payments which are tied to the OHIP claims system through shadow billing will receive the additional 9.95% increase for services rendered between January 1, 2025 and March 31, 2025.
The interim additional 9.95% compensation increase for the period of January 1, 2025 to March 31, 2025 will only apply to funding agreement items specified above, funding agreements and/or payment elements not listed above will be made through a subsequent payment process. Further details of this payment will be provided in a subsequent INFOBulletin.
Update your billing software
Please ensure that your billing software is updated to reflect the new FSC values for any services rendered on or after January 1, 2025, before submitting your claims.
The updated Fee Schedule Master will be available for download by January 7, 2025.
Claims processed through the OHIP claims system with service dates between January 1, 2025 and March 31, 2025 will reflect these increases and will be reported on your Remittance Advice.
Keywords/Tags
PSA; payments; physicians; Physicians Services Agreement; Primary Care; APP
Contact information
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